Dement Neuropsychol 2011 June;5(2):129-134 Original Article

Memory span measured by the spatial span

tests of the Cambridge Neuropsychological
Test Automated Battery in a group of Brazilian
children and adolescents
Rosani Aparecida Antunes Teixeira, Elaine Cristina Zachi,
Daniela Tsubota Roque, Anita Taub, Dora Fix Ventura

Abstract  –  The neuropsychological tests of spatial span are designed to measure attention and working memory.
The version of the spatial span test in the Cambridge Neuropsychological Test Automated Battery (CANTAB)
evaluates these functions through the recall of sequences of spatial locations presented to the subject. Objective:
The present study investigated how age, gender and educational level might affect the performance of the non-
verbal system. Methods: A total of 60 children and adolescents aged 6 to 18 years were assessed (25 males and 35
females). Results: The results showed no gender differences in test performance. Children with six or more years
of education showed better performance than children with less than three years of education. Older children
had more schooling and thus were able to recall a greater number of items. Span length values proved similar
to a previous large normative study which also employed the CANTAB Spatial Span (De Luca et al., 2003).
Conclusion: The similarity in performance of the Brazilian children and adolescents studied and the group of
Australian participants examined by the cited authors, despite the socio-cultural and economical differences,
points to the suitability of the task for the assessment of attention and working memory in Brazilian children.
Key words: neuropsychological tests, CANTAB, spatial span, working memory, children, educational status.

Capacidade de memória medida por testes de retenção espacial da bateria neuropspicologica computadorizada
de Cambridge em um grupo de crianças e adolescentes brasileiros
Resumo  –  Testes neuropsicológicos de span visuoespacial são construídos para avaliar amplitude atencional e
memória de trabalho. Na versão do teste de span visuoespacial da Cambridge Neuropsychological Test Automated
Battery (CANTAB) essa avaliação é feita através de sequências de localização espacial. Objetivo: O presente estudo
investiga como a idade, o sexo e a escolaridade podem afetar o desempenho nesse sistema não-verbal. Métodos:
Foram avaliadas 60 crianças e adolescentes com idades entre 6 e 18 anos (25 meninos; 35 meninas). Resultados:
Os resultados não mostraram diferenças no desempenho do teste entre os sexos. O grupo de crianças com seis
ou mais anos de escolaridade foi melhor do que a de crianças menores de três anos de estudo. Nossos resultados
sugerem que as crianças mais velhas e, portanto, com maior tempo de escolaridade conseguem se lembrar de
um número maior de itens. Os valores de amplitude foram similares aos obtidos em um experimento normativo
prévio amplo no qual foi utilizado o teste Spatial Span do CANTAB (De Luca et al., 2003). Conclusão: Estas
concordâncias de desempenhos entre crianças e adolescentes brasileiros e o grupo de participantes australianos
examinados pelos autores citados nos mostram que apesar das diferenças sócio-culturais e econômicas existentes,
a tarefa é adequada para avaliação de atenção e memória de trabalho em crianças brasileiras.
Palavras-chave: testes neuropsicológicos, CANTAB, spatial span, memória de trabalho, criança, nível de
escolaridade.

¹Instituto de Psicologia, Universidade de São Paulo, São Paulo SP, Brazil; 2Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo,
São Paulo SP, Brazil.
Rosani Aparecida Antunes Teixeira  –  Av. Prof. Mello Morais, 1721 / Bloco A / Sala D-9 - 05508-030 São Paulo SP - Brazil. Email: rosanit@usp.br
Disclosure: The authors reports no conflicts of interest.
Received March 02, 2011. Accepted in final form May 05, 2011.

Teixeira RAA, et al.     Memory span: Brazilian children and adolescents     129
 Dement Neuropsychol 2011 June;5(2):129-134

Memory span is “the ability to grasp a number of dizs- touch-screen computerized system that provides an accu-
crete units in a single moment of attention and to reprodu- rate neuropsychological assessment and latency recording.
ce them immediately”.1 Memory span assessment measures Some tests require a press pad, mainly those measuring
the ability to recall series of discrete stimuli, such as digits, reaction time.
letters, words, sounds, immediately after their presentation. The Spatial Span test is a computerized version of the
Practically every type of material can be used in test span Corsi Block Tapping Task6 and assesses the ability to re-
capacity.1 member a sequence of squares lighting up on the screen.
The Spatial Span Test is frequently considered a non- The Corsi Block Tapping task was developed in the early
verbal analogue of the Digit Span Test, which measures 1970s as a visuospatial counterpart to the verbal-memory
the capacity of visuospatial memory.2 The most frequently span task and has frequently been used to assess visuospa-
cited theoretical model in recent research on verbal short- tial short-term memory performance in adults, children
term memory development has been the Baddeley and and patients with neuropsychological deficits. Vandieren-
Hitch3 working memory model. donck and collaborators7 explored the information-pro-
Working memory is a limited capacity system serving cessing operations measured by the Corsi Blocks Tapping
to keep “active” a limited amount of information for a task within the working-memory framework developed by
brief period of time, and then to operate on it. The Badde- Baddeley and Hitch.3
ley and Hitch working memory model includes a central
component, the central executive, and three sub-systems: Methods
the phonological loop, the visuospatial sketchpad and the Subjects included 60 children and adolescents aged 6 to
episodic buffer.4 18 years (9.26±2.79 ys) with varying levels of formal edu-
In its original formulation3 this model proposed the cation (3.91±2.55 years). The children were recruited from
existence of two separate systems involved in working me- the Escola de Aplicação, Universidade de São Paulo, São
mory. These two systems handled different classes of infor- Paulo, Brazil. Exclusion criteria were history of head injury
mation: the articulatory loop handles speech-based (pho- and/or psychiatric illnesses. The procedures were approved
nological) information that allows auditory information by the Human Research Ethics Committee of the Universi-
to be held through a rehearsal mechanism that prevents its ty Hospital of the University of São Paulo (SISNEP CAAE:
rapid decay, and the visuospatial sketchpad handles visual 0026.0.198.000-06) and written informed consent was ob-
(e.g., color) and spatial (e.g., location) information allo- tained from participants or their guardians, prior to testing.
wing this information to be maintained and manipulated.4 The demographic characteristics of the participants are
The episodic buffer is an addition to the original summarized in Table 1.
working memory model. It was proposed by Baddeley in The Spatial Span Test is a test from the Cambridge
order to handle phenomena that were not covered by the Neuropsychological Test Automated Battery (CANTABe-
first model. In the revised model he intended to bring to- clipse)8 that assesses working memory capacity, and is a
gether and integrate the information from the other com- visuospatial analogue of the Digit Span test. In the Spatial
ponents of working memory, together with information Span Test, white squares are shown, some of which briefly
about time and order.4
The present study is concerned with memory for spa-
tial information and therefore assesses the visuospatial Table 1. Demographic features of children and adolescents in-
sketchpad proposed by Baddeley and Hitch. The aim was cluded in the study.
to investigate how age, gender and educational level might AGE Years of
affect the performance of the non-verbal system, using a (yrs) Total N Males Females schooling (SD)
modern computerized instrument called the Cambridge 6 7 4 3 1 (0)
Neuropsychological Test Automated Battery (CANTAB) 7 10 4 6 1.8 (0.42)
(Cambridge Cognition, 2005). The CANTAB was deve- 8 8 2 6 2.57 (0.53)
loped over 20 years ago at the University of Cambridge
9 8 3 5 3.25 (0.46)
by Robbins and Sahakian 5 for evalutation of cognitive
10 13 3 10 4.35 (0.49)
function.
The CANTAB is a computerized neuropsychological 11 5 3 2 5 (0)
battery consisting of 22 tests for assessing memory, atten- 12-18 9 5 4 8.22 (2.33)
tion and executive function. This software tool has been Total 60 24 36
widely used since the 1990s. Subjects are tested using a SD: standard deviation.

130     Memory span: Brazilian children and adolescents     Teixeira RAA, et al.
 Dement Neuropsychol 2011 June;5(2):129-134

change colour in a variable sequence. For each trial, nine
randomly arranged white squares are shown on the screen.
One by one the squares light up in colour, in a variable
sequence and children were instructed to remember the
sequence. At the end of the presentation, the children are
required to touch each of the boxes that had lit up, in the
same order in the first part of the test, and again in reverse
order in the second part. The task begins with the simplest
level of a two box sequence. After each successful trial, the
number of boxes in the sequence is increased one by one
to a maximum of nine. If the child’s response was incorrect
at any particular level, an alternate sequence of the same
length was presented. The test is terminated when the child
fails three consecutive trials at any one level.9
The measure obtained was the longest visual span, de-
fined by the maximum number of boxes the subject cor-
rectly touched.
Data analysis
To test whether the data were normally distributed,
Kolmogorov-Smirnov tests were run (Z=0.65, not signi-
ficant). Intergroup comparison between gender groups
and among different schooling levels were performed by
analysis of variance (ANOVA). Associations between span
scores and age were analyzed using regression models. The
significance level used was 0.05.
Results
No statistical differences were found between male
(n=24) and female (n=36) participants’ results on the vi-
sual span test for the items span forward and backward,
attempts forward and backward, or errors forward and
backward (Table 2).
Children and adolescents were divided into groups
according to years of schooling. Group 1 was comprised
by children with only one year of schooling, Group 2 by
those with two years of schooling, Group 3 three years of
schooling, Group 4 four years of schooling, Group 5 five
years of schooling, and Group 6 by children with six or
more years of schooling.
When the results of the same test were compared, no
statistical difference between the scores of forward and
backward Spatial Span was observed (p≥0.05) (Table 3).
The numbers of attempts increased with age, while the
numbers of errors decreased with age in almost all groups
(Table 4).
With regard to the variable years of schooling, sta-
tistical differences were found between groups with 1 yr
(p<0.01), 2 yrs (p<0.01), 3 yrs (p=0.01) versus 6 yrs on
forward span scores, and also between the 1 yr (p<0.01), 2
yrs (p=0.01), 3 yrs (p=0.01), 4 yrs (p=0.02) groups versus
the 6 year Group, on the backward span scores.
The analysis as a function of age compared the follo-
wing groups: 6 year-old children, 7-year-olds, 8-year-olds,
9-year-olds, 10-year-olds, 11-year-olds and 12-18 year-old
children.
Statistical differences were found for age between the
group of 6-year-olds (p=0.04) compared with 10 and 12-
18 year-olds, 7 year-olds (p<0.01), as well as between the
group of 9 year-olds (p<0.01) compared with 10 and 12 ye-

Table 2. Performance by gender.

Sex (n) Span forward Span backward Attempts forward Attempts backward Errors forward Errors backward
Male (24) 5.04 (1.54) 4.92 (1.65) 7.92 (2.30) 7.96 (2.35) 12.20 (6.01) 12.12 (5.39)
Female (36) 5.02 (1.36) 4.70 (1.65) 7.6 (1.81) 7.37 (2.26) 12.22 (5.02) 10.94 (5.01)
Mean (standard deviation).

Table 3. Performance by years of schooling.

Years of Forward Backward
schooling Span Mean Span Mean Forward attempts Backward attempts Forward errors Backward errors
(n) (SD) (SD) P-Value Mean (SD) Mean (SD) Mean (SD) Mean (SD)
1 (9) 3.66 (0.5) 3.33 (0.86) ≥0.05 6.0 (1.0) 5.66 (1.32) 10.33 (3.27) 8.33 (2.91)
2 (11) 4.63 (1.2) 4.45 (1.36) ≥0.05 7.0 (1.48) 7.18 (1.94) 11.63 (5.42) 10.91 (4.64)
3 (10) 4.8 (1.13) 4.3 (1.41) ≥0.05 7.40 (1.07) 7.70 (3.23) 11.80 (2.89) 12.40 (7.64)
4 (11) 5.2 (1.13) 4.8 (0.78) ≥0.05 8.70 (2.05) 7.50 (1.35) 14.90 (7.26) 12.0 (4.89)
5 (9) 5.2 (1.39) 5.1 (1.10) ≥0.05 8.0 (2.21) 7.70 (1.70) 12.10 (4.38) 10.60 (3.47)
≥6 (10) 6.6 (1.57) 6.3 (1.76) ≥0.05 9.40 (2.27) 9.80 (2.09) 12.40 (7.54) 14.20 (5.30)
SD (standard deviation).

Teixeira RAA, et al.     Memory span: Brazilian children and adolescents     131
 Dement Neuropsychol 2011 June;5(2):129-134

Table 4. Performance of different age groups.

Age Forward attempts Backward attempts Forward errors Backward errors
(n) Mean (SD) Mean (SD) Mean (SD) Mean (SD)
6 (7) 3.57 (0.53) 3.28 (0.95) 9.71 (2.36) 9.00 (2.94)
7 (10) 4.50 (1.80) 4.50 (1.35) 12.20 (6.01) 10.60 (4.99)
8 (8) 5.00 (0.75) 4.00 (0.92) 13.12 (4.76) 10.50 (3.96)
9 (8) 4.87 (1.45) 4.50 (1.69) 12.12 (4.29) 11.87 (8.23)
10 (13) 5.30 (0.94) 4.84 (0.55) 14.46 (6.09) 11.61 (4.50)
11 (5) 4.80 (1.78) 5.40 (1.34) 9.61 (2.07) 11.20 (4.54)
≥12 (9) 6.66 (1.65) 6.44 (1.81) 11.66 (7.61) 14.55 (5.50)
SD (standard deviation).

A B
r=0.53, p<0.01, y=2.47+0.27*x r=0.57, p<0.01, y=1.80+0.31*x
10 10
9 9
8 8
7 7
Span (Backward)
Span (Forward)

6 6
5 5
4 4
3 3
2 2
1 1
0 0
4 6 8 10 12 14 16 18 20 4 6 8 10 12 14 16 18 20
Age (years) Age (years)

Figure 1. Regression lines representing Spatial Span Performances according to age, Pearson’s coefficient (r), p-values, and regression equations.
[A] forward trial and [B] backward trial.

Table 5. Means and standard deviations for SSP by age group and
ar-olds, in the forward span scores, and between the groups
gender in present study and DeLuca17 study.
of 6-year-olds (p<0.01), 7 year-olds (p=0.02), 8 year-olds
(p=0.01), and 9 year-olds (p=0.03) compared with 12-18 SSP
year-olds, in the backward span scores. Present study DeLuca study
Linear regression analysis showed significant predic- N SPAN (SD) N SPAN (SD)
tion for better span performances by increasing age for 6-7 (years)
both forward trials and backward trials (Figure 1). Some     Male 8 4.50 (1.19)
points corresponded to more than one participant (e.g.     Female 10 4.00 (0.94)
four 6-year-old children showed the same span length on 8 -10 (years)
forward trial).
    Male 9 4.77 (1.30) 13 5.71 (0.91)
    Female 19 5.21 (0.91) 16 5.56 (1.09)
Discussion
11-14 (years)
In the present study, an automated version of the
    Male 7 5.42 (1.51) 13 6.46 (1.51)
spatial span task was used that is a variation on the Cor-
    Female 4 6.50 (2.51) 16 6.00 (1.20)
si Block-Tapping task, a manual test in which the target
locations are presented as nine wooden cubes fixed to a 15-19 (years)
wooden board.8     Male 1 5.04 (1.50) 18 7.76 (1.34)
Our results showed no statistical difference betwe-     Female 2 5.50 (0.70) 39 6.63 (1.50)

132     Memory span: Brazilian children and adolescents     Teixeira RAA, et al.
 Dement Neuropsychol 2011 June;5(2):129-134
en the sexes for span performance, although girls had a
higher average than boys at ages of between 8 to 14 years
on the forward span, while boys outperformed girls on the
backward span. This finding corroborates previous results
obtained with the Corsi Block-Tapping task in American
children and young adults,9 as well as in Brazilian chil-
dren10 where no statistical differences were found betwe-
en boys and girls. Similarly, Postma et al.11 also found no
statistical differences between the sexes in spatial working
memory. This is also true with regard to verbal span, as
concluded in the meta-analysis by Lynn and coauthors12
which showed no gender differences in the Wechsler di-
git span subtest. We believe that cognitive performance
differen­ces between genders, regardless of age, are relati-
vely small and can only be demonstrated by testing large
number of subjects.
Statistical comparisons of our results as a function of
years of schooling revealed no differences between forward
and backward SSP. Nevertheless, we noted that scores for
the backward SSP were consistently lower than for the
forward SSP.
We also report age differences in performance compa-
ring younger and older participants, showing that perfor-
mance improves with increasing age.
The Rosen et al. (1997)13 study in undergraduate stu-
dents showed that the forward and backward tasks reflect
different levels of processing complexity or different types
of representations. In their study however, no difference
between forward and backward scores were found, im-
plying that both tasks required a similar level of processing
complexity.
Kessels and collaborators2 also found no differences be-
tween the forward and backward condition on the Corsi
Block-Tapping Task (spatial span), but confirmed that the
Digit Span (verbal span) backward was more difficult than
the forward condition.
The analysis of the results as a function of educational
level revealed differences in performance among partici-
pants categorized in the first years of schooling and parti-
cipants in the final ranges of high school education, sho-
wing that performance improved with increased schooling,
and concomitant advancement in age. This expected result
had previously been demonstrated using the Corsi Block-
Tapping Task in children.10
Forward and backward span scores were positively cor-
related with age, suggesting improvement in span perfor-
mance with development. Luciana and Nelson9 suggested
that memory capacity measured by the span task does not
reach functional maturity by the age of 12. According to
the authors, 18 years is the age at which adult levels of per-
formance are attained on the CANTAB Spatial Span task.
Teixeira RAA, et al.     Memory span: Brazilian children and adolescents     133
Indeed, the fact that the groups with 1 to 3 years of scho-
oling committed significantly more errors than those with
more than 6 years of education may reflect an influence
of age. This increase in forward spatial span performance
with advancing age was also found using the Corsi Block-
Tapping task.14,15
The total number of errors is lower in reverse order be-
cause the test is stopped when the subject makes three con-
secutive errors. In direct order, mistakes tend to be made
throughout the test and therefore the total number of trials
and errors is higher. In reverse order, mistakes tend to be
made successively and in the early stages of the test. Post-
hoc comparisons confirmed that older children have better
performance on the spatial span task. This has also been re-
ported for other testing situations in previous studies.2,13,15,16
An extensive normative study was conducted by De-
Luca and collaborators.17 These authors investigated the
development of executive function over lifespan, in sub-
jects from 8 to 64 years old, and used several subtests of the
CANTAB, including the Spatial Span test. Figure 2 depicts
a comparison between our results and those obtained by
the cited authors.
A comparison between our results and those obtained
by DeLuca and collaborators17 showed that the span length
scores obtained by 5 out of 6 age groups in our sample
were within the range of norms described in that study. As
a limitation, our study sample included only one male and
two females in the 15 to 19 years age group. A larger sample
will provide further support for comparison.
Despite these limitations, the comparison between the
present data and results from the DeLuca and collabora-
tors17 study shows similarities in performance between the
Brazilian children and adolescents studied here and the
group of Australian participants examined by these au-
thors, despite the socio-cultural and economic differences.
In conclusion, our results do not show statistical diffe-
rences in performance on the Spatial Span Test due to gen-
der but observed differences in performance among partici-
pants in the first years of schooling compared to those in the
final ranges of high school education, show that performan-
ce improves with greater schooling, and the concomitant ad-
vancement in age. Our results also indicate a high applicabi-
lity of the Spatial Span of CANTAB for the Brazilian sample.
The ease of administration of the CANTAB allows its utili-
zation independent of subjects’ culture. The study showed
that the Spatial Span CANTAB test is a useful tool for asses-
sing pediatric samples in both research and clinical settings.
Funding sources  –  This study was supported by grants
from the Foundation for Research Support of the State
of São Paulo (FAPESP) Projeto Temático 02/12733-8 (to
 Dement Neuropsychol 2011 June;5(2):129-134
DFV), Doctoral Fellowship (05/53823-8) (ECZ), and Un-
dergraduate Fellowship (08/590001-8) (DTR). RAAT had a
Doctoral Fellowship from the National Council for Scien-
tific and Technological Development (CNPq) and DFV
holds a CNPq 1A Research Fellowship.
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